Is there anything that I should know or do going into my 4th IOP? Im tired of not getting anywhere!

20-year-old female; Duration of complaint- 10 years

5.5 feet 160 lbs

Currently diagnosed with GAD, Unspecified Depression

Currently prescribed 10 mg Buspar 2x a day, 70 mg Effexor in the morning, and 50-150mg Trazodone as needed for sleep; I recreationally use cannabis, but have discontinued daily use 4-5 months ago

I (20F) have been in and out of some form of therapy since I was 3. I started individual CBT for anxiety around dying, and then later group therapy at 5 for social anxiety. I stopped going consistently at 7 and have been on and off when things get too intense. I've been in 3 IOP programs now and many DBT classes, but I have never come away with anything more than relearning some coping mechanisms that don't stick around long.

My mom and all of her close friends are social workers or therapists, all of whom have been very helpful in my life by directing me towards what services they think I need. I read a note for a psych appointment I had 6 years ago about having a good psychiatric vocabulary, and I've been paranoid about it ever since. I've always been an overthinker and prone to researching intensively, so I get obsessed with getting better so I can go into appointments fully ready. I've been told by many professionals that people who are struggling don't know it, so things must not be too bad. I've been aware of my thought patterns and how I react to things for a few years now. But it feels like no matter how much I can see that how I feel doesn't make much sense, I always end up acting on (or having to fight) impulses or letting my negative thoughts take over me. 

My daily issues (for the past 10 years) have consisted of extreme reactions (suicidal ideation, threats, or attempts) when feeling like people hate me, having very extreme thoughts/not being able to see the nuance to any situation​​ or person, and generally obsessing over everything I think about. When I'm upset, I try grabbing sharp objects and fighting my parents when they intervene, jumping out of cars, packing up my stuff and running away, and living on the street by myself, quitting my job, and other things that I genuinely regret afterward. When I come out of however I feel, I either slip into some sort of depression (which no longer meets the criteria for an episode), get fixated on a new or random interest until its the only thing Im thining about, or go into an extremely anxious period where every random fear I have (death and what happens when we die, karma coming around) comes to the front of​​ my mind and those are my main concern. 

I always end up caught in a cycle of overreacting to situations and being overly sensitive, until my reactions are too extreme for my parents to handle, and I go into an IOP. I meet with a psychiatrist and therapist, whom I never hold on to for too long, and I use whatever few skills I had learned to sustain myself for however long until it happens again. A few professionals have suggested BPD, possibly Bipolar 2 (recommended Abilify, but my mom said no), or OCD. But I haven't done any real evaluations for anything and haven't had a sticking diagnosis of anything but GAD and Unspecified Depression with an accompanying SSRI, and a short-term diagnosis of Social Anxiety, MDD, and Panic Disorder (because I am prone to panic attacks when I get stuck in thought loops or overstimulated with noise). I don't have a history of abuse or any traumatic events, just many little things and an overall stressful life (finances, periodic homelessness, living with a relapsed alcoholic parent and grandmother who have a toxic relationship). When going over my family background and life makes it clear that I don't have PTSD, and easy to claim I'm having a hard time adjusting because some of my worst moments come after big events or shifts in my life. 

My parents sat me down and told me that my time between my intense reactions is getting shorter, and my anxiety when I'm not in emotional crisis is also out of control. I scheduled an appointment with my established psychiatrist, whom I haven't seen in almost a year, but still refills my prescription of 10 mg Buspar 2x a day, 70 mg Effexor in the morning, and 50-150mg Trazodone as needed for sleep. I also scheduled an appointment with a new psychologist, and he recommended me for IOP during the appointment. I have my intake on Monday, a psychiatry appointment on Tuesday, and a follow-up with the psychologist on Wednesday. I feel so exhausted by this cycle because I feel like I never get the help I need. They always realize there's clearly more going on than MDD or GAD, but it's not Bipolar 1 or 2, and I don't have psychosis. I deal with change really poorly, and I typically spiral in reaction to situations, so I always leave the an IOP being told the only thing wrong is that I have a hard time adjusting to things. I know this is a bit rambley, but if there's anything super obvious that professionals or I are missing (some type of specialized therapy or alternative diagnosis) that I need to be advocating for, please let me know. I feel really stuck.